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MO. CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
�,
AND UTILITY CONNECTION PERMIT
A/BSOiR t. white File
2. Pink City PERMIT NO. t 3_"'Gk I
3 Yellow Applicant
(Please type or print and sign at bottom)
,4„,.ADDRESS 15 251 W i t-Q5 Pfig Kwr ° N ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER '/ E( y />L13 71n1V 2 c
(Name) K lT (Phone) C/�2-- �r 1°i()7
(Address) ( 5.2.51 LA)1 L-O5 ti[l M40
BUILDER
(Company Name) 0 PRI i 0 iS &&E K10E CoAS`r. L L C (Phone) 612 384, 404
(Contact Name) O J t.0 Me (Phone)
(Address) L/5 W) 6 ic ar4 EL /11/& 1,97?? cc( � /J s S z
TYPE OF WORK 0 New Construction ['Deck ❑Porch ['Re-Roofing ['Re-Siding Aower Level Finish 0 Fireplace
❑Addition ['Alteration ['Utility Connection
CODE: 1LR.C. DLB.C. 0 Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ 3O 000
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above-mention• :roperty and that all construe' n will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can re his
1 r ju use. thermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
` rgCZO(3 y I 7r1i3
Signature CAtitractor's License No:- Date
Permit Valuation ko '- Park Support Fee # $
Permit Fee $ @ SAC _ # $
Plan Check Fee $
✓� �� Water Meter Size 5/8"; 1"; - -
State Surcharge $ 2 ' Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ c 4,;p Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
..
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee I $ c4-S;) TOTAL DUE $ ( 1 -7%
This App titin 3ecomes Your Building Permit en Ap oved Paid 1 Z-> Receipt�lpA l 7
Date 7 2,Z� By l�it//J
Buiidin, Official .........-/..."..
II'.
ate
This is to ce ify that e request in the above application and accompanying docume is is in ccordance with the City Zoning Ordinance and may proceed as requested. This document
when sign the J Planner congfiitutes a temporary Certificate of Zoning comp ance a allows construction to commence. Before occupancy,a Ceuffic ttf ccui ancy must be
issued. ■I
-\
i3 (3
Pt. IMPAttillitsb., Dat Special Conditions,if any ...----
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
p�pRI0 Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
r.3 g
E.02
BI¢e Pile
i.aura c;,y PERMIT NO. /2', 7417
3.Yellow Applical 6 /
_(Please type or print and sign at bottom)
ADDRES` ZONINNG(office use)
1° 4 5 a6/ W fr /Cis 7), #4114441 /LW
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(OWNER�G V`i V I!'��/h#3—IA. (Phone) U-) -7 I�'7 5/
(Address) (5-AS—r L /t —Pt2rt iLct/ u4 4 u i
APPLICANT t , • q
(Name) C u . _.„,a,4 / L / �ts
/L.' 0WM" ' "hone) 1 Li/A-V -/ /7
(Address) /(-Q / ' t4— — 7` i . _ %L i/. / A 6s"--"46
(Address) (City) ,, // (Zip Code)
(Contact Person) A I ►./ A '' (Phone) 1-'51 ` 5Z/ '°7
APPLICANT SIGNATURE (1 . ,_ _., - PIA J.— DATE /e..)._"7—
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher f Water Heater
Floor Drain / Water Softener
I Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
( Shower Stall Backflow Assembly
1 Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
J , Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family I%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
The Minnesota Statutes§326B.148 - est $ Building Permit#
"SURCHARGE"has been changed for one / 'Sv PAID WITH
year effective PLUMBING PERMIT FEE $
July 1,2010,until June 30,2011. STATE SURCHARGE $ BMILDING PER
r,
The minimum surcharge for a"fixed fee"permit TOTAL PERMIT FEE $ / al /�l g
Is S.a,beginning July 1,2010 �I
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
DEPAROF
PRIOR LAKE BUILDINGTMENT AND INSPECTION
INSPECTION RECORD
SITE ADDRESS C 6-2-S ( C-4)
NATURE OF WORK E cam _ L .
�.
USE OF BUILDING
PERMIT NO. (� -t?c 1 DATE ISSUED '7
CONTRACTOR b Itr-) g>z� Co..-92- PHONE !pt Z- 8�-, 4
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
—FOO
FOUNDATION (Prior Tn Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
C
FRAMING /de/7, —
INSUL
ELECTRICAL / �� �� /�
PLUMBING f5ue0. ///7 —
HEATING we /OM
FIREPLACE -
GAS LINE AIR TEST fvc Ayht e- j / 7, —
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections and
maintained until all inspections have been approved. On buildings and additions where no
service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850